Nurse Angela Sweeny pulls down the Class of 2019 Vaccination Records from a shelf in her office Nov. 9. Sweeny often has to access these records to send them to graduated students. photo by Julia Kerrigan

Vaccination: Opting out of Outbreak

The current debate over vaccinations follows the fraudulent Wakefield studies of 1998. This manifests itself in Missouri’s vaccination requirements allowing for medical and religious exemptions.

December 3, 2018

Catherine Tronnes, director of events a nonprofit and mother of three took her daughter to her first “chickenpox party” when she was just 2 years old. Here, the kids were encouraged to share snacks and sippy cups rather than scolded for it. The goal was to spread the disease from the one infected child to the rest of the community of unvaccinated children so that they would not catch it later in life and risk a more serious case.

“Everyone who went to the party ended up getting chickenpox,” Tronnes said.

These “pox playdates” were common before the introduction of the chickenpox vaccine in 1995 but now are rare to find as most medical professionals recommend the shot.

Based off bad experiences Tronnes had in her childhood with mistakenly getting additional vaccinations and her son’s violent reaction to them, she decided that her two daughters would not be immunized.

“I didn’t want to take the risk,” Tronnes said. “I researched and learned enough to make me feel comfortable. I think there’s just as much risk in the vaccines themselves as there are in the diseases they claim to prevent.”

This debate over vaccinations has been present since their introduction by English physician Edward Jenner in the early 1800s, but the current rise in opposition, specifically to the MMR (measles, mumps and Rubella) vaccine is largely due to the studies of former doctor Andrew Wakefield published in 1998. Emergency physician Dustin Urban from North Kansas City hospital has seen the results of anti-vaccination movements first hand and elaborates on the fraudulent study.

“Basically, a bad study was done that linked the MMR vaccine to autism which then led to a 10-year period where there was this big debate,” Urban said. “It came out that the doctor who did that study actually committed fraud and they had to remove the study from the record, but it has spurred the unsubstantiated belief that it has some link to autism.”

This specific side effect has been completely debunked. According to the National Center for Biotechnology Information, there is “no data supporting an association between MMR vaccine and autism,” and large-scale studies actually proved the opposite — there is no correlation. However, the resulting surge of the anti-vaccination movement has resulted in measles outbreaks, one of which Urban experienced a couple years ago in his hospital.

“I think I diagnosed the first case and until that, hadn’t seen one in the first seven or eight years of my practice,” Urban said. “In fact, most of the people I practice with have never seen measles before.”

Urban fully backs vaccinations.

“Vaccinations are the best way we’ve come up with for preventing [outbreaks],” Urban said. “Other than living in total isolation or just extreme hygiene measures, there’s really no other way to prevent it.”

According to the Center for Disease Control and Prevention, two doses of the MMR vaccine as a child allows a person to be considered protected for life.

“I mean, you get the pockets of people who don’t vaccinate and then you have susceptible children and then you can have an outbreak,” Urban said. “Whereas, if everyone is vaccinated, you never have an outbreak.”

These outbreaks are one of the reasons that, despite the arguments from the anti-vaccination movement, states are required to have school immunization policies. According to nurse Angela Sweeny, St. Teresa’s follows the Missouri set of requirements.

“We follow [vaccinations] closely,” Sweeny said. “One of the first things we do at St. Teresa’s is make sure everybody is immunized accurately and appropriately before they can attend here full time and that’s right off the bat.”

However, the Missouri policy allows exemptions to immunizations which must be kept on file for students to legally attend school. Tronnes’ son had a medical exemption from vaccinations upon school enrolment due to his seizures caused by the pertussis shot. For her daughters who had no documented reactions however, she had to procure a religious exemption.

“I don’t have any issue with [school vaccination policies] until and unless they start to not accept exemptions,” Tronnes said. “I don’t necessarily believe the herd immunity is something that I’m concerned with and so I’m far more the pariah in this situation.”

Sweeny is in support of these immunization requirements and Urban takes a similar position. He claims that although personal liberty is important, the public good needs to prevail when it comes to making decisions about vaccinating or not.

“I’m always one for people’s freedoms and being able to do what they want to do with their time,” Urban said. “But at the same time when it’s a public health issue, you’re putting other people at risk. I think it’s dangerous.”

According to the 2018-2019 Missouri School Immunization Requirements, “unimmunized children are subject to exclusion from school when outbreaks of vaccine-preventable diseases occur.” Tronnes finds this specific policy to conflict with her unvaccinated children’s best interests.

“Just because she’s not vaccinated, that’s my risk.” Tronnes said. “She’s not a risk to someone else and so to prohibit her from going to school just because she’s not immune seemed completely backwards. These other children who allegedly gotten vaccinations still got chickenpox so what does my kid’s status have to do with anything?”

Despite the allowance for exemptions with a doctor’s note, the number of STA students without immunizations has never been more than one or two out of a student body of about 600 each year during Sweeny’s five years at the school, and she expects it to remain consistently low.

“I think that [an increase in exemptions] would be unlikely unless there was research to show adverse reactions,” Sweeny said. “Immunizations have been around for so many years that I don’t know that that’s going to happen.”

Tronnes does not identify herself with the post-Wakefield anti-vaccination movement despite her aversion. She chose what she felt was right for her own family without any reference to what others do for theirs.

“I am not anti-vaccine,” Tronnes said. “I am for me. I try to just stay out of conversations that are extremist. In my opinion, vaccines are not safe and effective and not more so than the risks of not being vaccinated.”

Urban acknowledges the inherent risks associated with immunizations such as infections to the injection site and anaphylactic (allergic) reactions. However, he is steadfast in his belief in the science that backs vaccinations’ reliability.

“It’s not just a mild thing, I mean, people used to die of this stuff,” Urban said. “Compared to how many lives [vaccines] have saved, [adverse reactions are] a drop in the bucket.”

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